椎弓根钉棒系统固定加椎间植骨融合治疗腰椎滑脱18例

目的：探讨椎弓根钉棒系统固定加椎间植骨融合骨融合治疗腰椎滑脱症的临床疗效。方法：对18例腰椎滑脱患者行椎弓根钉棒系统固定加椎间植骨融合治疗。结果：随访平均19个月,全部患者中临床症状完全缓解16例,好转2例;14例患者完全复位,4例患者大部分复位,术后3－6个月复查x线显示,18例患者均获得椎体间骨性融合。结论：椎弓根钉棒系统固定加椎间植骨融合术治疗腰椎滑脱症具有固定可靠、植骨融合率高、近期、远期疗效确切等优点,值得临床推广使用。     

椎管扩大成形椎间融合治疗腰椎滑脱症68例临床分析

目的探讨椎管扩大成形、钉棒系统固定、Cage椎间植骨融合术治疗腰椎滑脱并椎管狭窄的手术方法及疗效。方法 2003年12月至2008年12月对87例腰椎滑脱并椎管狭窄患者应用椎管扩大成形、钉棒系统固定、Cage椎间植骨融合手术治疗,定期随访并行X线片检查。结果 68例获得随访,随访12~32个月,63例滑脱椎体完全复位,2例Ⅱ度滑脱和3例Ⅲ度滑脱复位达90.00%,解剖复位率为92.64%,钉棒系统及Cage位置满意,术后末次随访JOA评分平均26.4分,平均改善率为76.92%,临床疗效综合评价优良率为95.58%。结论椎管扩大成形、钉棒系统固定、Cage椎间植骨融合治疗腰椎滑脱症,消除了椎管狭窄、保持脊柱骨性三柱结构,是一种比较理想的治疗腰椎滑脱症的手术方式。     

椎间植骨融合内固定治疗腰椎滑脱的疗效分析

目的探讨椎间植骨融合内固定治疗腰椎滑脱症的临床疗效。方法 36例腰椎滑脱患者应用后路减压椎间植骨融合椎弓根钉棒内固定手术治疗,术中应用椎间融合器进行椎间融合、维持椎间隙高度,对滑脱椎体及其下位椎体行椎弓根钉固定。结果 34例患者术后滑脱完全复位,2例术后残留Ⅰ°滑脱。34例患者获得随访8～24个月,平均14.5个月,术后疗效评价优30例、良4例,34例患者椎间达到坚强融合。结论椎间植骨融合椎弓根钉棒内固定手术治疗腰椎滑脱症疗效理想、椎间融合率高,是较好的治疗方法。     

骨水泥强化椎弓根螺钉内固定减压椎间植骨融合治疗老年腰椎滑脱症

目的 探讨应用骨水泥强化椎弓根钉内固定、复位、减压、椎体间融合治疗老年骨质疏松患者腰椎滑脱症的临床疗效.方法 对19例老年骨质疏松患者腰椎滑脱症进行后路椎管减压,应用骨水泥强化椎弓根钉固定的方法对腰椎滑脱椎体进行复位固定,椎体间植骨融合.结果 随访7～24个月,临床优良率87%,6～12个月复查X线片均显示椎体间骨性融合,无椎弓根螺钉松动.结论 椎弓根螺钉经骨水泥强化后固定力增强,减少内置物失败,能有效提高椎体间植骨融合率,增加脊柱的稳定性,是治疗骨质疏松患者腰椎滑脱症的有效方法之一.     

通用型脊柱内固定系统治疗腰椎滑脱症

目的探讨应用通用型脊柱内固定系统（GSS系统）治疗腰椎滑脱症的疗效。方法对32例腰椎滑脱症患者行后路椎管开窗减压,应用GSS系统对滑脱椎体进行复位固定,椎体间植骨融合。结果32例随访6～36个月,临床优良率90%,6～18个月复查X线片均见椎体间骨性融合,复位无丢失,内固定未见松动、断裂。结论GSS系统复位内固定结合椎体间植骨融合治疗腰椎滑脱症,复位效果好、植骨融合率高,固定可靠。     

后路椎弓根钉内固定术治疗腰椎滑脱症32例

目的总结经后路椎弓根钉内固定,椎管减压复位联合椎间自体骨植骨融合器椎体间融合并横突间自体骨植骨融合治疗腰椎滑脱症的临床疗效。方法 32例腰椎滑脱症采用后路椎弓根钉将滑脱椎体提拉复位,椎管减压,椎间自体骨植骨融合器椎体间融合,横突间自体骨植骨的手术治疗方法评定,术中常规C型臂X线机监控下置钉和植入椎间融合器。结果术后随访6～36个月,平均24个月。其中优21例,良8例,可3例,优良率90.6%。结论后路椎弓根钉内固定,椎管减压复位,椎间融合并自体骨横突间植骨治疗腰椎滑脱症,具有创伤小,操作相对简单,复位融合率高,临床症状改善明显,是治疗腰椎滑脱症的有效方法。     

椎弓根螺钉固定及椎间加横突间植骨融合治疗退变性腰椎管狭窄症并腰椎滑脱52例

目的探讨通过后路腰椎管减压、椎弓根钉棒系统复位固定、椎间加横突间植骨融合的方法,治疗退变性腰椎管狭窄症并腰椎滑脱的临床疗效。方法对52例退变性腰椎管狭窄症并腰椎滑脱患者进行腰椎管减压,椎弓根钉棒系统复位内固定、椎间加横突间植骨融合进行治疗。结果46例随访10～34个月,优37例,良6例,可2例,差1例,优良率达93.2%。结论腰椎管彻底减压、椎弓根钉棒系统早期牢固固定和植骨部位骨性融合是保证疗效的关键。椎弓根钉棒系统固定及椎间加横突间植骨融合是治疗退变性腰椎管狭窄症并腰椎滑脱的一种理想的治疗方法。     

Cage椎间植骨融合结合钉棒内固定系统治疗腰椎滑脱症

目的探讨Cage椎间植骨融合结合钉棒内固定系统治疗腰椎滑脱症的临床疗效。方法该组24例经保守治疗无效的腰椎滑脱患者,采用Cage椎间植骨融合结合钉棒内固定系统手术治疗,并用JOA下腰痛手术评分系统评定临床症状的改善情况,影像学评价椎间隙高度、腰椎滑脱距离、滑脱角度的改变及椎间融合情况。结果术后所有病例未发生脑脊液漏、感染及神经根损伤。所有患者获6～12个月随访,患者术后1个月JOA评分、椎间隙高度、滑脱距离及滑脱角度,与术前比较,差异均有统计学意义(P<0.01)。术后6个月影像学检查22例患者植骨已融合,融合率为91.7%。结论 Cage椎间植骨融合结合钉棒内固定系统治疗腰椎滑脱症是一种安全有效的手术方法,临床疗效满意。     

钉棒系统加Cage融合器治疗腰椎滑脱症的临床应用

目的：探讨对腰椎滑脱症行钉棒系统加Cage融合器的临床应用价值。方法：回顾性分析36例腰椎滑脱患者行钉棒系统加Cage融合器的应用情况。结果：36例螺钉及Cage融合器均成功置入,术中无脊髓及神经根损伤。根据Suk标准证实本组椎体间植骨均融合,融合时间为3～24个月,融合率100%。内固定材料无松动、断裂,Cage融合器位置、形态正常,固定椎体间无移位,无滑脱无复发。根据邹德威评分标准,优28例,良6例,可2例,优良率达94.4%。结论：联合应用钉棒系统和Cage融合器治疗腰椎滑脱症可起到协同作用,能提供理想复位和坚强内固定,能够提高脊柱的融合率并维持良好的椎间隙高度和形态及腰椎生理性前凸,是治疗腰椎滑脱症的一种较理想方法。     

椎间植骨融合加椎弓根螺钉内固定治疗腰椎滑脱症39例疗效分析

目的 探讨椎间植骨融合加椎弓根螺钉内固定治疗腰椎滑脱症的临床疗效.方法 对39例腰椎滑脱患者采用椎弓根螺钉系统结合椎间植骨融合治疗,随访8～24个月,平均14个月,结合症状、体征改善情况及工作能力等进行疗效评价.结果 平均手术时间200 min,平均住院时间18 d;完全复位率92.3%(36/39);随访期间X线片复查复位满意,无椎间高度丢失以及内固定断钉、断棒、脱出等并发症;优良率为94.9%(37/39).结论 后路减压椎间植骨融合联合椎弓根螺钉系统复位效果良好、临床症状明显改善、并发症少,是治疗腰椎滑脱症的有效方法.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.